CMS recently received inquiries regarding procedural changes in the way that CMS’ Workers’ Compensation Review Contractor (WCRC) reviews proposed zero-dollar Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts. CMS determined changes had transpired without prior notification. Effective immediately, the WCRC will utilize procedures that were previously in effect. CMS continually evaluates all policy and procedures related to WCMSA reviews and will publish any pending changes when or before they go into effect.

Therefore, we are in a “wait and see” holding pattern until CMS publishes some additional guidelines. The good news is that we can confirm CMS is approving zero dollar MSAs as expected under the current system. Sedgwick has been in touch with CMS and we will provide feedback to CMS about how the proposed changes will adversely affect the settlement process.

Please watch for additional updates as we continue to provide you with the most up to date information. Please feel free to leave questions or concerns here and I will do my best to answer your questions.